JP2004081333A - Calculus crushing probe - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a calculus crushing probe that can effectively crush even a large calculus. <P>SOLUTION: By providing an insertion hole 10 in an ultrasonic calculus crushing probe 4, making the probe section 11 of a mechanical impact calculus crushing probe 5 insertable, and making a spikelike protrusion protrude and engage with a calculus when the probe section 11 is inserted, the probe can effectively crush a large calculus. <P>COPYRIGHT: (C)2004,JPO

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to a lithotripter for crushing and removing stones in a body.
[0002]
[Prior art]
As a calculus breaking means in the body, there is known a method of applying ultrasonic vibration to a calculus to a contact-type treatment probe, or a method of driving a probe in a longitudinal direction with a solenoid or explosive to apply a shock wave to the calculus. Since each crushing means has a characteristic, there is also a configuration in which crushing means are combined and combined as described in, for example, US Pat. No. 4,178,935.
[0003]
The contact type crushing means includes a method of transmitting ultrasonic vibration generated by a transducer at hand of the probe to the tip of the probe (ultrasonic lithotripsy), and a method of driving a probe in the longitudinal direction with a solenoid or explosive to apply a shock wave to a calculus ( Mechanical shock crushing).
[0004]
[Problems to be solved by the invention]
In the former case, since the high-frequency vibration having a short longitudinal stroke of vibration is transmitted to the calculus, the calculus is crushed so as to collapse, but the efficiency is low. The latter is suitable for breaking large lumps because it applies a single impact to the calculus, but has the characteristic that it is difficult to apply a probe so that the impact is transmitted to the calculus.
[0005]
In order to carry out a series of treatments efficiently, a large calculus is first divided into several blocks by mechanical impact crushing, and then the blocks are finely crushed with an ultrasonic crusher and collected.
[0006]
However, as described above, it is difficult to properly apply a mechanical impact crushing probe to a large calculus (the calculus escapes from the tip of the probe). Also, in order to crush a calculus divided into blocks, an ultrasonic lithotripsy probe is used. There was a problem that the location of the stone was lost.
[0007]
(Object of the invention)
The present invention has been made in view of the above problem, and has as its object to provide a crushed stone probe capable of efficiently crushing and removing even large stones.
[0008]
[Means for Solving the Problems]
A first probe connected to first mechanical energy generating means for generating first mechanical energy;
A second probe connected to a second mechanical energy generating means for generating a second mechanical energy different from the first mechanical energy;
An insertion hole formed in the first probe, through which the second probe can be inserted, and a protruding portion that can protrude from the side of the tip of the first probe in accordance with the insertion state of the insertion hole. ,
Is provided, a hole is formed in the target stone by the first probe, and then the second probe is set to the operating state in a state where the projection on the tip side is engaged with the hole by the second probe. By performing the crushing procedure, even large stones can be efficiently crushed.
[0009]
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, embodiments of the present invention will be described with reference to the drawings.
(First Embodiment)
1 to 4 relate to a first embodiment of the present invention. FIG. 1 shows the entire configuration of a crushed stone probe device provided with the first embodiment, and FIG. 2 shows a crushed stone according to the first embodiment. FIG. 3 shows a state in which a hole is formed in a calculus by the ultrasonic lithotripter, and FIG. 4 shows a state in which a mechanical impact crusher probe is formed after a deeper hole is formed. This shows a state where the distal end is inserted.
[0010]
As shown in FIG. 1, the crushed stone probe device 1 includes a crushed stone probe 2 according to the first embodiment of the present invention, and a probe driving device 3 connected to the crushed stone probe 2 and applying a drive signal to the crushed stone probe 2. Be composed.
The lithotripter probe 2 includes an ultrasonic lithotripter probe 4 and a mechanical impact lithotripter probe 5 that can be attached to the ultrasonic lithotripter probe 4.
[0011]
The ultrasonic lithotripter probe 4 comprises an elongated hollow probe portion 6 and a transducer portion 7 provided at the rear end of the probe portion 6 near the hand side and having a built-in ultrasonic transducer (transducer). A signal cable 8 connected to the ultrasonic vibrator extends from the side of 7, and a connector 9 at an end of the signal cable 8 is detachably connected to a first connector receiver provided on the probe driving device 3. You.
[0012]
The ultrasonic lithotripter probe 4 is provided with an insertion hole 10 along its longitudinal direction, through which the probe portion 11 of the mechanical impact crushed stone probe 5 can be inserted. An opening is provided at the rear end, through which the probe portion 11 of the mechanical impact crushed stone probe 5 can be inserted and withdrawn. Note that the front end side of the insertion hole 10 is formed by a hollow portion of the probe section 6.
[0013]
On the other hand, the mechanical shock crushed stone probe 5 is formed of, for example, a metal having an elongated and solid structure, and is provided with a probe portion 11 that can be inserted into the insertion hole 10 of the ultrasonic crushed stone probe 4 and a rear side of the probe portion 11 on the hand side. A signal cable 13 connected to (solenoid) extends from, for example, a rear end of the solenoid portion 12, and a second end portion of the signal cable 13 is provided. The connector 14 is detachably connected to a second connector receiver provided on the probe driving device 3.
[0014]
The probe driving device 3 is connected to, for example, a foot switch 15, and is operated by stepping on an ultrasonic lithotripter probe switch 16 and a mechanical shock crusher probe switch 17 provided on the foot switch 15. In addition, the lithotripsy treatment by the ultrasonic vibration by the ultrasonic lithotripter probe 4 and the lithotripsy treatment by the shock wave by the mechanical impact lithotripsy probe 5 can be performed.
[0015]
Two switches 16 for the ultrasonic lithotripter probe and two switches 17 for the mechanical impact crusher probe are provided, one is an ON switch for outputting a drive signal, and the other is an OFF switch for stopping the output of the drive signal. .
[0016]
In this case, both probe portions are configured so that the former can be combined in the longitudinal direction with a sheath and the latter as a sword.
As described above, in the present embodiment, two probes that generate different mechanical energies can be detachably combined and used.
[0017]
FIG. 2 is a sectional view of the probe unit 6 of the ultrasonic lithotripter probe 4. The probe section 6 includes an inner inner tube 21 and an outer tube 22. The distal end side of the inner inner tube 21 has a shape that is narrowed toward the distal end (that is, a shape whose diameter decreases toward the distal end side), and a plurality of spike-like projections 23 are provided at positions slightly away from the distal end. It is provided so as to protrude outward.
[0018]
A plurality of cuts (grooves) 24 cut in the longitudinal direction are provided on the distal end side of the inner cylindrical tube 21 from the distal end toward the hand side, and the base end of the cut 24 starts to narrow. It almost matches the position.
On the other hand, the outer tube 22 is provided with an opening 25 at a position corresponding to the above-mentioned projection 23.
[0019]
The ultrasonic vibration generated by the transducer unit 7 is transmitted to the probe 6. On the other hand, the outer diameter of the probe portion 11 of the mechanical impact crushed stone probe 5 is slightly smaller than the inner diameter of the inner cylinder tube 21 and can be inserted into the inner cylinder tube 21. (Or the solenoid drive unit 12 drives the probe unit 11 toward the distal end (so as to project it with a larger amplitude than in the case of ultrasonic vibration).
[0020]
The probe 11 can be used in a state of being inserted into the hollow probe section 6 described above.
In a state where the ultrasonic lithotripter probe 4 and the mechanical impact lithotripsy probe 5 are combined, the tip positions of the probe section 6 and the probe section 11 are the same, or the probe section 11 is slightly located at the tip.
[0021]
Next, the operation of the present embodiment will be described.
First, the tip of the probe unit 6 of the ultrasonic lithotripsy probe 2 is applied to the calculus, and the ON switch of the ultrasonic lithotripsy probe switch 16 of the foot switch 15 is operated. A drive signal for ultrasonic excitation is applied to the transducer, and the ultrasonic transducer vibrates ultrasonically.
[0022]
The ultrasonic vibration is transmitted by the probe unit 6, and the tip of the probe unit 6 enters the calculus so as to make a hole in the calculus. FIG. 3 shows a state in which a small hole 32 is formed in the calculus 31.
[0023]
When the tip has entered the calculus 31 to some extent, for example, as shown in FIG. 4, the probe section 11 of the mechanical impact crushed stone probe 5 is inserted. As the distal end of the probe 11 is inserted to the position located at the base end of the depression, the distal end of the inner cylindrical tube 21 is expanded by the distal end of the probe 11. With the deformation of the tip of the inner cylindrical tube 21, the projection 23 projects laterally through the opening 25, and the projection 23 is locked to the calculus 31 (in other words, the tip of the crushed stone probe 2 is 23 is set in a state of being locked to the calculus 31).
[0024]
Thereafter, the solenoid driving unit 12 is driven to generate a mechanical shock wave. The impact is transmitted to the probe section 11 and is effectively transmitted to the calculus 31 having its tip locked. That is, since the calculus 31 is locked by the projection 23, the impact is reliably transmitted to the calculus 31 without escaping, and the calculus 31 can be efficiently crushed.
[0025]
In this way, when the large formed stone 31 can be crushed into a plurality of small calculi, the ultrasonic lithotripsy probe switch 16 is further operated to crush the stone by ultrasonic waves and set the size so that it can be removed from the body. Good.
[0026]
In addition, it is not necessary to further perform the lithotripsy by ultrasonic vibration for a calculus that can be set to a size that can be discharged to the outside of the body by a mechanical impact.
[0027]
In the above description, the lithotripsy treatment of a large calculus was described. However, in the case of a small calculus, the lithotripsy can be crushed only by the ultrasonic lithotripsy probe 4.
[0028]
In other words, according to the present embodiment, in addition to performing the lithotripsy treatment for a small calculus, in the case of a large calculus, the lithotripsy is crushed by the mechanical impact lithotripsy probe 5 inserted into the ultrasonic lithotripsy probe 4 and thereafter required. Accordingly, the lithotripsy treatment can be performed to a size that can be removed by the ultrasonic lithotripsy probe 4.
[0029]
As described above, according to the present embodiment, the positional relationship between the calculus and the tip of the mechanical shock crushing probe is maintained, so that even large calculi can be reliably broken, and the probe is not inserted or removed after dividing into block pieces. Therefore, it is possible to provide a crushed stone probe capable of efficiently crushing a large calculus, because it is possible to shift to crushing (crushing) by ultrasonic waves without losing an object.
In addition, this procedure makes it possible to shorten the operation time of calculus crushing, and reduce the physical and mental burden on the patient / operator.
[0030]
(Second embodiment)
Next, a second embodiment of the present invention will be described with reference to FIG. An object of the present embodiment is to provide a crushed stone probe and a crushed stone probe device that can efficiently crush and remove even large stones.
[0031]
FIG. 5 shows a crushed stone probe device 1B provided with a second embodiment of the present invention. The crushed stone probe device 1B is different from the crushed stone probe device 1 of FIG. 1 in that a suction device 41 is further provided, and a front end of a suction tube 42 having a rear end connected to the suction device 41 is provided after the insertion hole 10 in the ultrasonic crushed stone probe 4. It can be detachably connected to a base 43 forming an opening at the end.
[0032]
That is, when crushing a large calculus, as shown in FIG. 1 or FIG. 5, the mechanical impact crushed stone probe 5 is attached to the rear end (the base 43 forming an opening) of the insertion hole 10 of the ultrasonic crushed stone probe 4. The crushing treatment can be performed by inserting the probe unit 11.
[0033]
With this crushing treatment, for the calculus reduced to such a degree that it is not necessary to crush with the mechanical shock crushing stone probe 5, the mechanical shock crushing stone probe 5 is removed from the insertion hole 10 and the front end of the suction tube 42 is connected to the base 43. Connecting.
[0034]
Then, by setting the suction device 41 to the suction operation state, the small-sized calculus is sucked and discharged out of the body, and the calculus which cannot be suctioned is crushed by the ultrasonic probe 4 to a small size, and the calculus is sucked. And drain it out of the body.
[0035]
In the case of a small calculus, the suction tube 42 is connected to the base 43 without using the mechanical impact lithotripsy probe 5 and crushed by the ultrasonic probe 4 to a small size, which is sucked and discharged out of the body. can do.
[0036]
When the calculus is crushed by the ultrasonic probe 4, the suction means is set in a suction state, and the distal end opening of the probe unit 6 of the ultrasonic probe 4 is applied to the calculus to be crushed. It can hold and transmit ultrasonic waves efficiently to the calculus side, and can be crushed.
[0037]
Further, even when the hole 32 is formed in the large calculus 31 as shown in FIG. 3, the hole 32 can be formed more reliably by setting the suction means in the suction state.
[0038]
According to the present embodiment having such a configuration and operation, since the suction means is also provided, it can be efficiently crushed even in the case of a large calculus, and further, the calculus in the body is efficiently removed by suction and discharge. be able to.
[0039]
In addition, the pain hole 10 can be used as a means for sucking and discharging a calculus, and can also be used for inserting the probe portion 11 of a mechanical impact lithotripsy probe 5, so that crushing can be appropriately performed according to the calculus to be (crushed) removed. You can take action.
[0040]
As a modified example of the second embodiment, for example, the base 43 is branched into two branches so that the probe part 11 of the mechanical impact crushed stone probe 5 can be inserted into the straight side, and the other side is inclined. A structure may be employed in which a suction tube can be connected to the side formed as described above.
In this case, the probe section 11 of the mechanical impact crushed stone probe 5 can be inserted and removed with the suction tube connected.
[0041]
In this case, the insertion hole 10 allows the probe portion 11 of the mechanical impact crushed stone probe 5 to be inserted in a substantially fitted state. For example, not only a circular section but also a part thereof is not fitted. A structure in which a notch portion is formed such that a groove portion capable of suction along the direction is formed, and even when the probe portion 11 of the mechanical impact crushed stone probe 5 is inserted, the tip thereof is sucked by suction means. May be applied to maintain a state (or a locked state) in which the is applied to the calculus.
Further, if the stone can be locked by the suction force, locking with the projection 23 is not necessarily a necessary component.
[0042]
[Appendix]
0. The first mechanical energy according to claim 1, wherein the first mechanical energy is ultrasonic vibration energy, and the second mechanical energy is shock wave energy.
1. An ultrasonic lithotripter with an ultrasonic generator at the base end, a mechanical crusher with a mechanical shock generator at the base end is a crushed stone probe,
A lithotripter probe comprising: means for projecting a projection laterally beyond the outer diameter of the latter as the mechanical impact crusher probe is inserted into the ultrasonic lithotripter probe.
[0043]
2. An ultrasonic lithotripter having an ultrasonic generator at its base end, and a mechanical impact crusher probe inserted into a through hole provided in the ultrasonic lithotripter probe, thereby providing an ultrasonic lithotripter mechanical impact crusher probe. A crushed stone probe characterized in that a crushing treatment by means of crushing is enabled.
3. In Supplementary Note 2, suction means can be connected to the insertion hole.
4. In Supplementary Note 2, the projection can be made to protrude laterally on the tip side of the ultrasonic crushed stone probe by inserting the mechanical shock crushed stone probe.
[0044]
5. An ultrasonic lithotripter with an ultrasonic generator at the base end, and a suction means connected to the rear end of the insertion hole provided in the ultrasonic lithotripter probe, so that the calculus can be suctioned and discharged through the insertion hole. A crushed stone probe characterized in that a mechanical impact crushed stone probe can be inserted into the insertion hole and crushing treatment by the mechanical impact crushed stone probe is enabled.
[0045]
6. An ultrasonic lithotripter with an ultrasonic generator at the base end,
Mechanical shock crushed stone probe which can be inserted through an insertion hole provided in the ultrasonic crushed stone probe,
A driving device for supplying a signal for driving the ultrasonic lithotripter and the mechanical shock crusher probe,
A suction device that suctions through a connection tube at a rear end of the insertion hole,
Crushing probe device equipped with
[0046]
7. In Supplementary Note 6, a projection can be projected laterally on the tip side of the ultrasonic crushed stone probe by inserting the mechanical shock crushed stone probe.
[0047]
【The invention's effect】
[0048]
【The invention's effect】
As described above, according to the present invention, a mechanical shock crushing stone probe is inserted into the insertion hole of the ultrasonic lithotripsy probe, and the crushed stone is locked to the calculus by a protrusion that projects laterally from the distal end side of the ultrasonic lithotripsy probe. Can be set to effectively break large stones.
[Brief description of the drawings]
FIG. 1 is an overall configuration diagram of a crushed stone probe device provided with a first embodiment of the present invention.
FIG. 2 is a diagram showing a structure on the tip side of an ultrasonic lithotripter forming the crushed stone probe of the first embodiment.
FIG. 3 is a diagram showing a state in which a hole is formed in a calculus using an ultrasonic lithotripter.
FIG. 4 is a view showing a state in which the distal end side of the mechanical impact crushed stone probe is inserted after forming a deeper hole from the state of FIG. 3;
FIG. 5 is an overall configuration diagram of a crushed stone probe device provided with a second embodiment of the present invention.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 ... Crushed stone probe device 2 ... Crushed stone probe 3 ... Probe drive unit 4 ... Ultrasonic crushed stone probe 5 ... Mechanical impact crushed stone probe 6,11 ... Probe part 7 ... Transducer part 8,13 ... Signal cable 10 ... Insertion hole 12 ... Solenoid Part 15 Foot switch 21 Inner tube 22 Outer tube 23 Spike-like projection 24 Cut 25 Opening 31 Calculus 32 Hole

Claims (1)

A first probe connected to first mechanical energy generating means for generating first mechanical energy;
A second probe connected to a second mechanical energy generating means for generating a second mechanical energy different from the first mechanical energy;
An insertion hole formed in the first probe, through which the second probe can be inserted, and a protruding portion that can protrude from the side of the tip of the first probe in accordance with the insertion state of the insertion hole. ,
A crushed stone probe comprising:

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